Somerfield Te Kura Wairepo Permissions 2024
Welcome to 2024 at Somerfield Te Kura Wairepo. Please fill in this important document before the Getting Connected interview.


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Child's name
Parent 1 Name
Parent 1 Email
Parent 1 Address
Parent 1 Phone number
Parent 2 Name
Parent 2 Email
Parent 2 Address
Parent 2 Phone Number
Emergency Contact Name
Emergency Contact Email
Emergency Contact Address
Emergency Contact Phone Number
Some of the contact details for my child have changed *
Class for 2024
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Person completing the form
SECTION 2: USE OF STUDENT'S NAME
Images of our students (photographs, video clips, etc.), and examples of their school work, are sometimes published in our newsletter, on our school website, and other online channels such as the school/class blogs, Facebook page, You Tube, etc.  The purposes of publishing student material are to educate our students according to the national curriculum, to encourage students to participate in our school community, and to promote the school.

  We believe it is important to celebrate children’s achievement, but are aware of the potential risks when such personal information or material is published on a global information system such as the Internet.  In the interest of safety and security we require parents to give permission for their child’s first name, image, or work to be made public.

I give permission for my child's first name , image, or work to be published in the school newsletter, on the school website, or the wider online community
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SECTION 3- VOLUNTEER AGREEMENT
If you anticipate being a volunteer on a school trip, please read and sign this form.  If there is more than one parent who will be volunteering please have both sign this section of the form).

With the introduction of the Vulnerable Children’s Act we are introducing new mechanisms to ensure children are kept safe.  Information will be kept on file and used repeatedly for the current year.  Confidentiality will be maintained.

As a volunteer assistant in the school or at an EOTC event:

I am willing to comply with requests of staff and follow safety procedures they have set.
I am willing to assist in aspects of running the event, based on information I have supplied.
I agree that I am bound by the school Privacy policy and will maintain confidentiality regarding children and families at school.
I agree that I am bound by the Alcohol, Drugs and other Harmful Substances policy and will not be consuming or be under the influence of alcohol, illegal substances when supervising or in the presence of students.
I agree that I am bound by the Smoke free policy and will not smoke anywhere on the school grounds, including the road patrol area and EOTC venue, or when supervising students.

I agree to the above volunteer agreement
SECTION: EDUCATION OUTSIDE THE CLASSROOM
Education Outside the Classroom (EOTC) is the name given to all events and activities that occur outside the classroom, both on
school grounds, and off-site. Our students participate in a wide range of learning opportunities within and outside the school
grounds. Senior students participate in a wide range of sporting events outside the school throughout the year. All class teachers are encouraged to provide extension and enrichment opportunities for their students. These learning opportunities sometimes require travel outside the school.
The school uses a process to identify and manage risks at every level and this process is monitored by the board and the principal.

We recognise four levels of activities, each with specific requirements regarding parental/caregiver consent.
Level Activity

1. At school, or within the immediate local environs, for example, sport events, fun days, nature studies, and includes involvement in the aquatics programme . Consent required: Blanket permission provided on enrolment.

2. Off-site events occurring entirely in school time and finishing no later than 4pm, e.g.,
zone sports, team sport events, class trips to the museum. Parents are advised of the
finishing time if it is later than 3.15pm.
Consent required: Blanket permission provided on enrolment, but parents are
informed that the event is to occur.

3. Off-site or on-site events occurring in one day involving risk assessed to be greater
than that associated with the average family activity, for example, water activities
(apart from swimming sports), rock climbing.
Consent required: Parent/caregiver informed consent is required for each specific
event.

4. Events occurring overnight, for example, school camp.

Consent required: Parent/caregiver informed consent is required for each specific
event.
I give permission for my child to participate in level 1 and 2 Education Outside the classroom activities for this school year. I understand that that for any level 3 and 4 activitity, I will be provided with a specific consent form.
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SECTION 5- CATERING
To ensure we are inclusive when catering, eg, sausage sizzles please add up to date food allergy information
Please list the other allergies here
Is there anything you want to administration staff to me aware of about your child?
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